Veterinary Neurologic Rehabilitation: The Rationale for a Comprehensive Approach.

The increase in client willingness to pursue surgical procedures, the heightened perceived value of veterinary patients, and the desire to provide comprehensive medical care have driven the recent demand of using an integrative treatment approach in veterinary rehabilitation. Physical therapy following neurologic injury has been the standard of care in human medicine for decades, whereas similar rehabilitation techniques have only recently been adapted and utilized in veterinary medicine. Spinal cord injury is the most common neurologic disease currently addressed by veterinary rehabilitation specialists and will be the primary focus of this review; however, research in other neurologic conditions will also be discussed. Of particular interest, to clients and veterinarians are techniques and modalities used to promote functional recovery after neurologic injury, which can mean the difference between life and death for many veterinary patients. The trend in human neurologic rehabilitation, often regardless of etiology, is a multimodal approach to therapy. Evidence supports faster and improved recoveries in people after neurologic injury using a combination of rehabilitation techniques. Although the primary neurological disorders researched tend to be spinal cord injury, peripheral neuropathies, allodynia, multiple sclerosis, and strokes-many correlations can be made to common veterinary neurological disorders. Such comprehensive protocols entail gait training activities in combination with neuromuscular electrical stimulation and directed exercises. Additionally, pain-relieving and functional benefits are bolstered when acupuncture is used in addition to rehabilitation. Studies, both laboratory and clinical, support the use of acupuncture in the management of neurologic conditions in small animals, specifically in cases of intervertebral disc disease, other myelopathies, and neuropathic pain conditions. Acupuncture's ability to promote analgesia, stimulate trophic factors, and decrease inflammation, including neuroinflammation, make it an alluring adjunct therapy after neurologic injury. Although there is limited research in veterinary medicine on physical techniques that expedite recovery after neurologic injury, there are sparse publications on clinical veterinary research suggesting the benefits of acupuncture, rehabilitation, and LASER in dogs with intervertebral disk disease. Accordingly, due to the relative lack of evidence-based studies in veterinary neurologic rehabilitation, much of the data available is human or laboratory-animal based, however, evidence supports the utilization of an early, comprehensive treatment protocol for optimal neurologic recovery. The rationale for why an integrative approach is critical will be detailed in this review; in addition, literature on specific physical rehabilitation techniques that have evidence of improved recoveries after neurologic injury, will be addressed.

Divergent bornaviruses from Australian carpet pythons with neurological disease date the origin of extant Bornaviridae prior to the end-Cretaceous extinction.

Tissue samples from Australian carpet pythons (Morelia spilota) with neurological disease were screened for viruses using next-generation sequencing. Coding complete genomes of two bornaviruses were identified with the gene order 3'-N-X-P-G-M-L, representing a transposition of the G and M genes compared to other bornaviruses and most mononegaviruses. Use of these viruses to search available vertebrate genomes enabled recognition of further endogenous bornavirus-like elements (EBLs) in diverse placental mammals, including humans. Codivergence patterns and shared integration sites revealed an ancestral laurasiatherian EBLG integration (77 million years ago [MYA]) and a previously identified afrotherian EBLG integration (83 MYA). The novel python bornaviruses clustered more closely with these EBLs than with other exogenous bornaviruses, suggesting that these viruses diverged from previously known bornaviruses prior to the end-Cretaceous (K-Pg) extinction, 66 MYA. It is possible that EBLs protected mammals from ancient bornaviral disease, providing a selective advantage in the recovery from the K-Pg extinction. A degenerate PCR primer set was developed to detect a highly conserved region of the bornaviral polymerase gene. It was used to detect 15 more genetically distinct bornaviruses from Australian pythons that represent a group that is likely to contain a number of novel species.

Acupuncture for Small Animal Neurologic Disorders.

Modern research on traditional Chinese veterinary medicine (TCVM), including herbal medicine and acupuncture, has made evident the role of the nervous system as a cornerstone in many of the mechanisms of action of TCVM. Laboratory models and clinical research available are supportive for the use of TCVM in the management of neurologic conditions in small animals, specifically in cases of intervertebral disk disease, other myelopathies, and painful conditions. This article is meant to help guide the use of TCVM for neurologic disorders in small animals, based on available information and recommendations from experienced TCVM practitioners.

Doenças neurológicas em cães atendidos no Hospital Veterinário da Universidade Federal de Santa Maria, RS: 1.184 casos (2006-2013) / Neurological diseases in dogs examined at the Veterinary Teaching Hospital of the Federal University of Santa Maria, RS: 1.184 cases (2006-2013)

Foi realizado um estudo retrospectivo de cães atendidos no Serviço de Neurologia (SN) do Hospital Veterinário Universitário (HVU) da Universidade Federal de Santa Maria (UFSM), de 2006 a 2013, com o objetivo de identificar e caracterizar a idade, a raça, o sexo e as doenças neurológicas e classificá-las de acordo com a região anatômica e o acrônimo DINAMIT-V. Foram avaliadas 1.277 fichas neurológicas de cães e obtidas as informações para inclusão no estudo em 1.184 delas, sendo o diagnóstico confirmado em 525 cães (44,4%) e presuntivo em 659 (55,6%). A raça mais frequente foi Dachshund (28,7%), seguida dos cães sem raça definida. Os locais mais afetados foram medula espinhal entre T3-L3 (40,9%) e tálamo-córtex (17,5%). A maioria dos cães foi diagnosticada com doença degenerativa (49%), sendo a doença do disco intervertebral a mais observada, seguida das doenças inflamatórias/infecciosas (16,6%). Pode se concluir que a maior prevalência das doenças neurológicas de cães envolve a medula espinhal e o tálamo-córtex, sendo as degenerativas as mais frequentes e os dados obtidos podem auxiliar em futuros estudos sobre a frequência e a distribuição das principais doenças neurológicas em cães.

A retrospective study including dogs with neurological disease was conducted at the Service of Neurology (SN) of the Veterinary Teaching Hospital, Universidade Federal de Santa Maria (UFSM) from 2006 to 2013, with the objective to identify and characterize age, breed, sex and to neurological diseases, and classify them accordingly to the anatomical region and DINAMIT-V acronym. There were evaluated 1,277 neurological records of dogs and obtained the information for inclusion in the study in 1,184 of them being the diagnosis confirmed in 525 (44.4%) and presumptive in 659 dogs (55.6%). The most common breed was Dachshund (28.7%), followed by mixed breed. The most affected sites were the spinal cord between T3-L3 (40.9%) and thalamus-cortex (17.5%). Most dogs were diagnosed with degenerative disorders (49%), being intervertebral disk disease the most observed, followed by inflammatory/infectious diseases (16.6%). It can be concluded that the higher prevalence of neurological disorders in dogs involve the spinal cord and thalamus-cortex, with the most frequent being degenerative and the data obtained may assist future studies associated with frequency and distribution of the main neurological diseases in dogs.

Doenças do sistema nervoso de bovinos no Mato Grosso do Sul: 1082 casos / Diseases of the nervous system of cattle in Mato Grosso do Sul, Brazil: 1082 cases

Foi realizado um estudo retrospectivo de janeiro de 2008 a dezembro de 2012 com base nos laudos de necropsia do Laboratório de Anatomia Patológica (LAP) da Faculdade de Medicina Veterinária e Zootecnia (FAMEZ), Universidade Federal de Mato Grosso do Sul (UFMS), com o intuito de descrever quais as doenças que afetam o sistema nervoso de bovinos que ocorrem no Mato Grosso do Sul. Os casos consistiam de acompanhados por técnicos do LAP e encaminhados por médicos veterinários que atuam no campo (autônomos ou do serviço veterinário oficial). De 1082 materiais analisados, 588 apresentavam histórico de sinais clínicos neurológicos. Destes, 341 (53,75%) tiveram diagnóstico correspondente a doenças neurológicas e 247 (46,25%) tiveram diagnóstico inconclusivos. As fichas clínico epidemiológicas foram revisadas para determinar dados referentes a epidemiologia, aos sinais clínicos e às alterações macroscópicas e microscópicas. O botulismo (16,67%), a raiva (15,92%), a polioencefalomalacia (8,05%) e a encefalite por herpesvirus bovino (4,31%) foram as enfermidade de maior frequência. Outras doenças como meningoencefalite não supurativa (2,62%), meningoencefalite supurativa (1,50%), abscessos cerebrais e osteomielite por compressão medular (1,31%), tétano (1,12%), hipotermia (0,94%), babesiose cerebral (0,75%), febre catarral maligna (0,37%) e lesões sugestivas de intoxicação por oxalato (0,19%) foram ocasionalmente diagnosticadas. Em nenhum dos casos foram observadas lesões que pudessem sugerir encefalopatia espongiforme bovina.

The aim of this study was to describe the types of diseases that affect the nervous system of cattle from the State of Mato Grosso do Sul, Brazil. A retrospective study from January 2008 to December 2012 was perfomed, based on reports of cattle autopsies autopsy carried out by the Laboratório de Anatomia Patológica (LAP), Faculdade de Medicina Veterinária e Zootecnia (FAMEZ), Universidade Federal de Mato Grosso do Sul (UFMS). The material came from cases attended and forwarded to LAP by practicing veterinarians autonomous and from the official veterinary service. From 1028 cases studied, 588 presented a history of neurological clinical signs, 341 (53.75%) of which were diagnosed as affected bytrue neurological disease, and 247 (46.25%) had inconclusive diagnosis. The clinical records were reviewed to determine epidemiology, clinical signs, and gross and histopathological features. The most frequent diseases were botulism (16.67%), rabies (15.92%), polioencephalomalacia (8.05%), and herpesviral meningoencephalitis (4.31%). Other conditions were diagnosed occasionally, and included non suppurative meningoencephalitis (2.62%), suppurative meningoencephalitis (1.50%), brain abscesses and osteomyelitis caused by spinal cord compression (1.31%), tetanus (1.12%), hypothermia (0.94%), cerebral babesiosis (0.75%), malignant catarrhal fever (0.37%), and cases suggestive of oxalate poisoning (0.19%). No cases with lesions that may suggest of bovine spongiform encephalopathy were observed.

Physical rehabilitation of the canine neurologic patient.

Rehabilitation therapy is a key component of recovery from neurologic disease. Each patient requires a rehabilitation protocol designed specifically for the patient's neurologic condition, owner expectations and level of participation, and expertise of the veterinary team. Initial therapy for nonambualtory patients may include standing exercises, range of motion, pain control, toe pinch exercise, aquatic exercise, and basic nursing care. Sling assisted walking with foot protection, cavaletti rails, and physioroll balancing are used commonly for ambulatory patients. As recovery progresses, stair climbing, carrying or pulling weights, resistance band walking, swimming against resistance, and exercises specific to the home environment are added. Modalities such as electrical stimulation, ultrasound, cryotherapy, and heat therapy are useful adjuncts but do not take the place of active exercise.

Prognostic indicators for nonambulatory cattle treated by use of a flotation tank system in a referral hospital: 51 cases (1997-2008).

OBJECTIVE: To evaluate clinical variables assessed during the first 24 hours of hospitalization as prognostic indicators for nonambulatory cattle treated by use of a flotation tank. DESIGN: Retrospective case series. ANIMALS: 51 nonambulatory cattle that underwent flotation treatment. PROCEDURES: Signalment, history, serum biochemical analyses, patient behavior during flotation, and outcome data were collected from medical records. Outcome was survival to discharge from the hospital or nonsurvival (death or euthanasia). Data were analyzed by use of Wilcoxon rank sum, Fisher exact, and chi(2) tests. RESULTS: 19 of 51 cattle survived. Survivors and nonsurvivors did not differ significantly with regard to median weight; age; stage of lactation; duration of recumbency prior to flotation; serum potassium, ionized calcium, or phosphate concentrations at admission to the hospital; or serum creatine kinase activity (value at admission to the hospital, highest value, and last recorded value). Cattle that were able to walk out of the tank after the first flotation treatment were 4.8 times as likely to survive as those that could not. Cattle that did not eat during flotation treatment were 1.9 times as likely to die as those that ate. Cattle that stood apparently normally on all limbs during the first flotation treatment were 2.9 times as likely to survive as those that had an asymmetric stance or were unable to stand. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that objective variables evaluated during the first 24 hours of hospitalization and flotation treatment are associated with outcome among nonambulatory cattle; findings might assist in logical decision making with respect to treatment options.

Neurologic disease putatively associated with ingestion of Solanum viarum in goats.

Several Nubian-cross goats were evaluated because of chronic progressive neurologic disease. Physical and neurologic examination revealed signs consistent with diffuse cerebellar disease. Neurologic signs included generalized hyperresponsiveness, fine head tremors, wide-based posture, dysmetria, weakness, and horizontal nystagmus. No clinical improvement was noted after removing goats from affected enclosures. Histologic examination of cerebellar tissues revealed extensive vacuolation within the cytoplasm of Purkinje cells. The clinical and histologic lesions resembled closely findings that were associated with ingestion of Solanum spp in cattle and goats. Examination of enclosures revealed Solanum viarum (tropical soda apple) that had been heavily consumed by the goat herd. We hypothesized that ingestion of S. viarum caused the neurologic disorder.

Complementary and alternative medicine for neurologic disorders.

The use of complementary and alternative veterinary medicine in treating neurologic disorders has increased in popularity in response to advances in human alternative and integrative therapies. Neurolocalization of lesions to the brain, spinal cord, and neuromuscular systems is discussed, as well as the diagnostics and therapeutics used to treat such disorders. Emphasis is placed on integrative and alternative treatments for such neurologic diseases as seizures, cerebrovascular accidents, canine cognitive disorder, meningitis, intervertebral disc disease, fibrocartilagenous embolism, degenerative myelopathy, and myopathies. Thorough physical and neurologic examinations, establishment of a correct diagnosis, and integrative therapeutics are aimed at improving the overall quality of life of the veterinary patient.

[Rehabilitation methods in small animal neurology]. / Rehabilitationsmassnahmen in der Kleintierneurologie.

Rehabilitation is an important part of the treatment of neurological diseases. The primary goal of these methods is an optimal functional restoring of the neuro-muscular system. Massages, thermo-, hydro- and electrotherapy, as well as therapy of movement are different treatment possibilities with their own indication, which are combined in a physiotherapy program. It follows an overview of the different physiotherapeutic methods and their application in some of the most common neurological diseases, as for example intervertebral disc problems or degenerative myelopathy.

Ionized and total serum magnesium concentrations in feline renal transplant recipients.

OBJECTIVE: To measure the blood concentrations of total and ionized serum magnesium in feline renal transplant recipients and to determine if there was a correlation between these concentrations and the development of neurological disorders after renal transplantation. STUDY DESIGN: Prospective clinical study. ANIMALS: Fourteen client-owned cats undergoing renal transplantation as a treatment for renal failure. Ten healthy adult cats were used to establish normal electrolyte concentrations. METHODS: Total and ionized serum magnesium as well as potassium and ionized calcium concentrations were measured in 14 renal transplant recipients at five intervals: preoperatively; immediately postoperatively; and 24, 48, and 120 hours postoperatively. The mean values from all 14 cats over each time interval were compared with the normal range. The serum concentration of these electrolytes, particularly magnesium, was evaluated in relation to the occurrence of neurological complications. RESULTS: Ninety-four percent of all ionized serum magnesium concentrations measured in clinical patients were below normal. Ninety percent of all total serum magnesium concentrations were within the normal range, and no cats had abnormally low total serum magnesium concentrations at any time. All clinical patients were hypocalcemic at all intervals. Sixty-six percent of all serum potassium concentrations were below normal. One cat in the study group experienced neurological problems, including seizures, in the immediate postoperative period. The signs appeared to be related to hypertension and responded to appropriate therapy. All electrolyte concentrations in this cat, including ionized magnesium, were within the same range of values as other clinical patients. CONCLUSIONS: Ionized serum magnesium concentrations are decreased in feline renal transplant recipients in the perioperative period; however, hypomagnesemia would not appear to be directly related to the development of neurological disorders. None of the study patients were hypomagnesemic when total serum magnesium concentrations were measured over the same intervals. In addition, ionized serum calcium concentrations and serum potassium concentrations are below normal in the perioperative period. CLINICAL SIGNIFICANCE: The specific clinical significance of these abnormalities is unknown. It is possible that the profound weakness and depression that is commonly seen in feline renal transplant recipients in the immediate postoperative period may be improved by supplementation with these electrolytes. Further work is needed to understand the implications of these abnormalities.

Toxicology of Astragalus lusitanicus Lam.

Astragalus lusitanicus is a toxic legume grown in Morocco and in some other Mediterranean countries. In small ruminants, poisoning by this plant is dominated by nervous signs characterized by many cycles of excitement-depression. Macroscopic examination of poisoned animals showed congestive lesions and oedema in the brain and lungs. Microscopic lesions consisted mainly of vacuolar degeneration in neurons, hepatocytes and in spleen and kidney cells. Serum activity of AST and CK as well as blood glucose and urea were increased as a result of poisoning. However, serum activity of alpha-mannosidase was not modified as is the case in locoism. Chemical investigations showed that A. lusitanicus does not contain swainsonine or miserotoxin and its selenium concentration is very low. However, this legume contains indolizidin alkaloids and a first compound was purified and identified.

Equine degenerative myeloencephalopathy.

EDM is a neurologic disease of young horses characterized by the insidious development of symmetric ataxia. Decreased or absent cutaneous trunci reflex or slap test responses are considered clinical signs that increase the index of suspicion for this disease. In addition, concurrent predisposing factors, such as familial history, inadequate access to green pasture, and possible exposure to wood preservatives or insecticides, provide further supporting evidence for a clinical diagnosis. Vitamin E deficiency and a hereditary predisposition currently are considered the most significant factors in the pathogenesis of this disease. Histopathologically the lesions of EDM are those of neuraxonal dystrophy, characterized by prominent axonal and dendritic swelling, mild glial proliferation, and neuronal depletion and atrophy with lipofuscin-like pigment accumulation. Animals predisposed to EDM or with a clinical diagnosis of EDM should receive oral alpha-tocopherol acetate supplementation. Improvement in clinical signs may be seen following long-term treatment, but in general, the prognosis for complete recovery is poor.

Ultrastructural neuropathology of chronic wasting disease in captive mule deer.

Chronic wasting disease (CWD), a progressive and uniformly fatal neurological disorder, is characterized neuropathologically by intraneuronal vacuolation, spongiform change of the neuropil and astrocytic hyperplasia and hypertrophy. Ultrastructural neuropathological findings consist of (1) extensive vacuolation in neuronal processes, within myelin sheaths, formed by splitting at the major dense lines or within axons; (2) dystrophic neurites (dendrites, axonal preterminals and myelinated axons containing degenerating mitochondria and pleomorphic, electron-dense inclusion bodies); (3) prominent astrocytic gliosis; (4) amyloid plaques; and (5) giant neuronal autophagic vacuoles. Other findings include activated macrophages and occasional spheroidal structures containing densely packed fibrillar material of unknown origin, abundant structures suggestive of degenerating microtubules entrapped in filamentous masses, vacuoles and myelin figures. Similar findings have been previously observed in scrapie-infected hamsters and Creutzfeldt-Jakob disease (CJD)-infected mice, bovine spongiform encephalopathy, and CJD indicating that CWD in captive mule deer belongs to the subacute spongiform encephalopathies (transmissible brain amyloidoses).

Naturally occurring selenosis in Wyoming.

A review of Wyoming State Veterinary Laboratory records for 1947-1987 revealed no substantiated cases of naturally occurring selenosis. However, older reports attributed thousands of animal deaths to selenium each year in this area. Beginning in August 1988, cases of suspected selenosis and selenium deficiency were solicited from veterinarians and producers by announcements in various statewide livestock publications. As of August 1991, 4 cases (all horses) of naturally occurring selenosis have been confirmed. Clinical signs were most often referable to epithelial damage, e.g., hoof lesions and loss of mane and tail. None involved neurologic signs. Sources of selenium included native range and grass hay.

Neurologic evaluation and its relation to acupuncture. Acupuncture for neurologic disorders.

Acupuncture provides companion animal veterinarians a valid therapeutic alternative to medicine and surgery in a variety of neurologic disorders. The veterinarian must arrive at a lesion localization in the nervous system and determine a presumptive diagnosis before instituting acutherapy. Signalment, type of neurologic disorder, efficacy of conventional treatments versus acupuncture, financial constraints, and ethical issues are useful patient selection criteria. In general, animals experiencing pain respond faster and more completely to acupuncture than those demonstrating neurologic deficits consistent with loss of function. Acupuncture offers clients a noninvasive alternative when medications are contraindicated or surgery is not an option. This chapter serves as an introduction to acupuncture for neurologic disorders in pets. It is hoped that the information here will inspire clinical investigations to evaluate more completely patient selection, patient response, and long-term outcome.

Neurologic manifestations associated with hypothyroidism in four dogs.

Hypothyroidism was believed responsible for peripheral and central neurologic abnormalities in 4 dogs. Clinical signs consisted of abnormalities of gait and postural reactions and dysfunction of multiple cranial nerves in all 4 dogs. Circling, hypermetria, and spontaneous verticle nystagmus were observed in some of the dogs. Hypothyroidism was diagnosed in all 4 dogs on the basis of low resting serum thyroxine concentration and inadequate response to thyroid stimulating hormone. After thyroid hormone supplementation, resolution of neurologic abnormalities was complete in 2 dogs and partial in the other 2 dogs.

Physiopathologic changes in lambs fed with Astragalus lusitanicus Lam.

A study was made of acute experimental poisoning of lambs with A lusitanicus Lam. The animals suffered a nervous syndrome with physiopathologic changes in blood and cerebrospinal fluid indicative of nervous alterations. A lusitanicus Lam causes a form of "locoism" whose development may involve a thiamine deficiency.

Effects of methylphenidate on whirler mice: an animal model for hyperkinesis.

The neurological mutant whirler mouse, one of several strains of waltzing mice, may be suitable as an animal model for testing studies relative to hyperkinesis. As in hyperkinetic children, behaviorally the mice are extremely restless, nervous, excitable, irritable and aggressive but also show symptoms of rotation behavior, head-shaking and deafness. This study demonstrated that paradoxically oral intubation of daily doses of 5.0 mg/kg of methylphenidate during a 23 week period significantly decreased circling activity in test mice. The effects on circling behavior were reversible following cessation of methylphenidate administration. After 18 weeks of cessation of the CNS stimulant, oral administration of a single dose of 2.5 mg/kg of methylphenidate caused a 37.8% increase in circling activity but the increase compared to control whirler mice was not significant. Use of this strain as an animal model may be especially beneficial in the screening of new drugs for the treatment of hyperkinesis.